Gabon

加蓬
  • 文章类型: Journal Article
    背景:耐甲氧西林金黄色葡萄球菌(MRSA)是细菌抗菌素耐药性导致死亡的主要原因之一。虽然金黄色葡萄球菌在非洲的皮肤和软组织感染(SSTI)中很常见,关于MRSA比率的数据很少,整个大陆的报告差异很大(5%-80%).在这项研究中,我们描述了在Lambaréné引起SSTI的MRSA的比例,加蓬,在11年的时间里。
    方法:我们回顾性分析了从AlbertSchweitzer医院SSTI住院和门诊患者收集的953个细菌样本的数据,Lambaréné,加蓬,2009年至2019年。我们确定了MRSA患病率的时间变化,并确定了SSTI伴MRSA的危险因素。
    结果:所有细菌生长的标本中有68%产生金黄色葡萄球菌(n=499/731),其中7%(36/497)的抗菌药物敏感性试验被鉴定为MRSA.年龄在18岁以上,进入外科病房,深部感染与MRSA作为病原体显著相关.在从2009年的7%开始下降之后,在2012年至2019年期间,来自SSTI的所有金黄色葡萄球菌中MRSA的比例从3%显着增加到20%。MRSA对红霉素的耐药率显着高于甲氧西林敏感的金黄色葡萄球菌(73%vs.10%),而克林霉素耐药仅在MRSA分离株中检测到(8%)。
    结论:在过去的11年中,引起SSTI的MRSA比例不断增加,这与许多MRSA下降的欧洲国家形成对比。在医院和社区中持续监测MRSA谱系以及抗生素管理计划可以解决MRSA增加的趋势。
    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of mortality due to bacterial antimicrobial resistance. While S. aureus is common in skin and soft tissue infections (SSTI) in Africa, data on MRSA rates are scarce and reports vary widely across the continent (5%-80%). In this study, we describe the proportion of MRSA causing SSTI in Lambaréné, Gabon, over an 11-year period.
    METHODS: We retrospectively analyzed data from 953 bacterial specimens collected from inpatients and outpatients with SSTI at the Albert Schweitzer Hospital, Lambaréné, Gabon, between 2009 and 2019. We determined temporal changes in the prevalence of MRSA and identified risk factors for SSTI with MRSA.
    RESULTS: 68% of all specimens with bacterial growth yielded S. aureus (n = 499/731), of which 7% (36/497) with antimicrobial susceptibility testing were identified as MRSA. Age above 18 years, admission to the surgical ward, and deep-seated infections were significantly associated with MRSA as the causative agent. After an initial decline from 7% in 2009, there was a marked increase in the proportion of MRSA among all S. aureus from SSTI from 3 to 20% between 2012 and 2019. The resistance rate to erythromycin was significantly higher in MRSA than in methicillin-susceptible S. aureus (73% vs. 10%), and clindamycin resistance was detected exclusively in MRSA isolates (8%).
    CONCLUSIONS: The increasing proportion of MRSA causing SSTI over the 11-year period contrasts with many European countries where MRSA is on decline. Continuous surveillance of MRSA lineages in the hospital and community along with antibiotic stewardship programs could address the increasing trend of MRSA.
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  • 文章类型: Journal Article
    背景:尽管登革热病毒(DENV)在十年前在加蓬爆发,对该国DENV血清型的潜在循环知之甚少。以前在该国某些地区进行的研究,仅限于以医院为基础的调查,该调查报告了7年前出现的一些血清型2和3病例,最近出现的血清型1病例。作为进一步的调查,我们将调查扩展到MoyenOgooué地区社区,旨在评估登革热病毒血清型的存在,此外,以表征基孔肯雅(CHIKV)感染并描述与感染相关的症状学。
    方法:于2020年4月至2021年3月进行了横断面调查。该研究包括男女和一岁及以上任何年龄的参与者,在过去七天有发烧或发烧史,直到采血。符合条件的志愿者进行了临床检查,收集血液样品,使用RT-qPCR检测DENV和CHIKV。选择阳性样品用于靶测序。
    结果:共纳入579名志愿者。他们的平均年龄(SD)为20(20)岁,其中55%为女性。在我们的队列中,诊断出4例DENV感染,患病率为0.7%(95CI:0.2-1.8),而未检测到CHIKV病例。DENV病例表现出的常见症状和体征包括疲劳,关节痛肌痛,咳嗽,和食欲不振。DENV-1是通过RT-qPCR检测到的唯一病毒。
    结论:我们的结果证实该地区存在活跃的登革热感染,特别是DENV-1,并可能提示DENV-2和DENV-3的下降。持续监测对于全面描述加蓬Moyen-Ogoué地区登革热血清型分布的程度仍然至关重要。
    BACKGROUND: Despite dengue virus (DENV) outbreak in Gabon a decade ago, less is known on the potential circulation of DENV serotypes in the country. Previous studies conducted in some areas of the country, are limited to hospital-based surveys which reported the presence of some cases of serotype 2 and 3 seven years ago and more recently the serotype 1. As further investigation, we extend the survey to the community of Moyen Ogooué region with the aim to assess the presence of the dengue virus serotypes, additionally to characterize chikungunya (CHIKV) infection and describe the symptomatology associated with infections.
    METHODS: A cross-sectional survey was conducted from April 2020 to March 2021. The study included participants of both sexes and any age one year and above, with fever or history of fever in the past seven days until blood collection. Eligible volunteers were clinically examined, and blood sample was collected for the detection of DENV and CHIKV using RT-qPCR. Positive samples were selected for the target sequencing.
    RESULTS: A total of 579 volunteers were included. Their mean age (SD) was 20 (20) years with 55% of them being female. Four cases of DENV infection were diagnosed giving a prevalence of 0.7% (95%CI: 0.2-1.8) in our cohort while no case of CHIKV was detected. The common symptoms and signs presented by the DENV cases included fatigue, arthralgia myalgia, cough, and loss of appetite. DENV-1was the only virus detected by RT-qPCR.
    CONCLUSIONS: Our results confirm the presence of active dengue infection in the region, particularly DENV-1, and could suggest the decline of DENV-2 and DENV-3. Continuous surveillance remains paramount to comprehensively describe the extent of dengue serotypes distribution in the Moyen-Ogooué region of Gabon.
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  • 文章类型: Systematic Review
    目的是阐明自1980年以来加蓬疟疾流行病学的时空变化。为此,五个数据库,用于收集和鉴定1980年至2023年之间发表的关于疟疾流行的所有研究,抗疟药耐药性,抗疟药抗性标记和杀虫剂抗性标记。研究结果表明,加蓬继续将疟疾作为一个紧迫的公共卫生问题,患病率持续较高。尽管CQ退出,但抵制CQ的标志仍然存在,并且对SP的抗性标记以很高的频率出现,达到100%,而ACTs仍然有效。此外,最近的研究已经确定了对杀虫剂Kdr-w和Kdr-e的抗性标记,频率范围为25%至100%。据报道,Ace1R突变的频率为0.4%。总之,ACTs的疗效仍高于WHO建议的阈值.有机磷酸盐和氨基甲酸酯可以为病媒控制提供替代方案。
    The objective of this were conducted to elucidate spatiotemporal variations in malaria epidemiology in Gabon since 1980. For that, five databases, were used to collect and identify all studies published between 1980 and 2023 on malaria prevalence, antimalarial drug resistance, markers of antimalarial drug resistance and insecticide resistance marker. The findings suggest that Gabon continues to face malaria as an urgent public health problem, with persistently high prevalence rates. Markers of resistance to CQ persist despite its withdrawal, and markers of resistance to SP have emerged with a high frequency, reaching 100 %, while ACTs remain effective. Also, recent studies have identified markers of resistance to the insecticides Kdr-w and Kdr-e at frequencies ranging from 25 % to 100 %. Ace1R mutation was reported with a frequency of 0.4 %. In conclusion, the efficacy of ACTs remains above the threshold recommended by the WHO. Organo-phosphates and carbamates could provide an alternative for vector control.
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  • 文章类型: Journal Article
    疟疾按蚊对家庭环境的适应与它们以人类为食的能力直接相关。这种物种-栖息地关联的强度在属内的物种之间是不平等的,主要载体特别依赖于人类。然而,我们对血液喂养行为如何与环境环境相互作用和适应环境的理解,包括人类的存在,仍然有限。使用基于字段的方法,我们首先在加蓬的拉洛佩国家公园调查了按蚊群落结构和摄食行为模式,中非。我们使用跨蚊子物种的双宿主选择采样方法对偏好指数进行了表征,栖息地,和季节。然后,我们量化了每个栖息地中蚊子的塑料叮咬行为。我们从16种按蚊物种中收集了个体,这些按蚊物种在种属和家庭环境之间的物种组成和丰度上显着差异。在七个最丰富的物种中,寻找宿主的行为也有所不同。对每个主人的总体吸引力,人或动物,对每个物种保持相对恒定,但是不同物种的栖息地之间存在显著差异。这些变化,更多的通才和更多的嗜人行为,与季节变化和与村庄的距离有关,分别。最后,我们指出,在没有人类的情况下,主要疟疾媒介的宿主选择发生了变化,揭示了这些物种的塑料喂养行为。这项研究强调了人类对按蚊分布和摄食进化的影响。野生和家庭环境中摄食行为的表征为更好地了解寄主偏好的遗传决定因素与生态因素之间的相互作用提供了机会。我们的发现表明,保护区可能为主要疟疾病媒提供替代的繁荣条件。
    The adaptation of Anopheles malaria vectors to domestic settings is directly linked to their ability to feed on humans. The strength of this species-habitat association is unequal across the species within the genus, with the major vectors being particularly dependent on humans. However, our understanding of how blood-feeding behavior interacts with and adapts to environmental settings, including the presence of humans, remains limited. Using a field-based approach, we first investigated Anopheles community structure and feeding behavior patterns in domestic and sylvatic settings in La Lopé National Park in Gabon, Central Africa. We characterized the preference indices using a dual-host choice sampling approach across mosquito species, habitats, and seasons. We then quantified the plastic biting behavior of mosquito species in each habitat. We collected individuals from 16 Anopheles species that exhibited significant differences in species composition and abundance between sylvatic and domestic settings. The host-seeking behavior also varied among the seven most abundant species. The general attractiveness to each host, human or animal, remained relatively constant for each species, but with significant variations between habitats across species. These variations, to more generalist and to more anthropophilic behavior, were related to seasonal changes and distance from the village, respectively. Finally, we pointed out that the host choice of major malaria vectors changed in the absence of humans, revealing a plastic feeding behavior of these species. This study highlights the effect of humans on Anopheles distribution and feeding evolution. The characterization of feeding behavior in wild and domestic settings provides opportunities to better understand the interplay between genetic determinants of host preference and ecological factors. Our findings suggest that protected areas may offer alternative thriving conditions to major malaria vectors.
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  • 文章类型: Journal Article
    肢体残疾的灵长类动物在野外的存活已被广泛报道。然而,他们的最终命运几乎没有记录在案。从保护的角度了解肢体残疾对灵长类动物生存的影响是很重要的,许多非洲类人猿因陷于圈套中而遭受肢体伤害。这里,我们报告了在一个大型的野生西部低地大猩猩中,一个单臂的黑人雄性的死亡。受试者是一个名叫渡渡鸟的黑人男性(14岁),在2008年8月失去了右前臂.2019年12月8日,渡渡鸟被发现身体前部严重出血,包括大面积的撕裂伤和刺伤.12月14日,他的尸体在森林中被发现。我们提供证据表明他的受伤更有可能是由种内侵略引起的,尽管不能完全排除豹子的掠夺性攻击。他的单臂残疾可能使他更容易受到大猩猩或豹子的攻击,并导致他的致命伤害。这份报告显示,以前在童年时期克服一只手臂残疾的大猩猩可能会过早死亡,在某种程度上,由于年轻时的这种残疾。
    The survival of limb-disabled primates in the wild has been widely reported. Nevertheless, their ultimate fate is little documented. It is important to understand the influence of limb disability on primate survival from a conservation perspective, as many African great apes suffer from limb injuries caused by entrapment in snares. Here, we report the death of a one-armed blackback male in a large one-male group of wild western lowland gorillas. The subject was a blackback male (14 years old) named Dodo, who lost his right forearm in August 2008. On 8 December 2019, Dodo was found to have suffered serious bleeding injuries to the front of his body, including large lacerations and puncture wounds. On 14 December his corpse was found in the forest. We provide evidence to suggest that his injuries were more likely caused by intraspecific aggression, though a predatory attack by a leopard could not be completely ruled out. His one-armed disability could have made him more vulnerable to attack from either a gorilla or leopard and led to his fatal injury. This report shows that a gorilla who had previously overcome a disability in one arm in childhood may die prematurely, in part, owing to this disability in young adulthood.
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  • 文章类型: Journal Article
    杯状病毒(Caliciviridae)和星状病毒(星状病毒科)是人类非细菌性食源性疾病和胃肠炎的主要原因。这些无包膜RNA病毒感染包括啮齿动物在内的多种脊椎动物物种。啮齿动物是全球最重要的传染病宿主之一,并负责影响人类的80多种人畜共患病原体。因此,在啮齿动物中筛查病原体对于防止跨物种传播以防止人畜共患暴发是必要的。在本研究中,我们筛选了杯状病毒和星状病毒,以描述它们的多样性,以及它们是否含有可以感染人类的菌株。然后从245只啮齿动物的肠样品中提取RNA,并在cDNA中逆转录,以通过PCR筛选杯状病毒和星状病毒。所有样品的杯状病毒检测均为阴性,而在18个(7.3%)的鼠鼠类样品中检测到了星形病毒。基于RdRp基因的系统发育分析表明,所有序列都属于Mamastrovirus属,其中它们与先前在加蓬或Rattusspp中检测到的与R.rattus相关的AstV具有遗传相关性。来自肯尼亚和亚洲的AstV。这些发现表明,陆地和铁路等交通,以及国内和国际贸易,可能通过啮齿动物的传播促进AstV的传播。
    Caliciviruses (Caliciviridae) and astroviruses (Astroviridae) are among the leading cause of non-bacterial foodborne disease and gastroenteritis in human. These non-enveloped RNA viruses infect a wide range of vertebrate species including rodents. Rodents are among the most important hosts of infectious diseases globally and are responsible for over 80 zoonotic pathogens that affect humans. Therefore, screening pathogens in rodents will be is necessary to prevent cross-species transmission to prevent zoonotic outbreaks. In the present study, we screened caliciviruses and astroviruses in order to describe their diversity and whether they harbor strains that can infect humans. RNA was then extracted from intestine samples of 245 rodents and retrotranscribed in cDNA to screen caliciviruses and astroviruses by PCRs. All the samples tested negative for caliciviruses and while astroviruses were detected in 18 (7.3%) samples of Rattus rattus species. Phylogenetic analyses based on the RdRp gene showed that all the sequences belonged to Mamastrovirus genus in which they were genetically related to R. rattus related AstVs previously detected in Gabon or in Rattus spp. AstV from Kenya and Asia. These findings suggested that transportation such as land and railway, as well national and international trade, are likely to facilitate spread of AstVs by the dissemination of rodents.
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  • 文章类型: Journal Article
    急性呼吸道感染是资源有限国家的主要全球负担。包括非洲国家。尽管自从加蓬出现疫情以来,COVID-19已经得到了充分的研究,中部非洲,对其他呼吸道病毒性疾病的关注较少,可用的数据很少。在这里,我们提供了有关COVID-19大流行期间加蓬18种主要呼吸道病毒的遗传多样性和检测的第一批数据。2020年3月至2021年7月采集的582例SARS-CoV-2阴性鼻咽拭子标本中,156人对以下病毒呈阳性(26%):肠道病毒(20.3%),人鼻病毒(HRV)(4.6%),人类冠状病毒OC43(1.2%),人腺病毒(0.9%),人偏肺病毒(hMPV)(0.5%),甲型流感病毒(IAV)(0.3%),和人类副流感病毒(0.5%)。确定病毒的遗传多样性和传播途径,使用检测到的病毒的基因组序列进行系统发育分析.在这项研究中检测到的IAV菌株在遗传上与在美国分离的菌株相似,而属于A2b亚型的hMPV菌株与肯尼亚菌株形成簇。这项研究提供了第一个完整的HRV基因组序列,IAV,在加蓬检测到的hMPV,并深入了解该国呼吸道病毒的传播情况。
    Acute respiratory infections are a major global burden in resource-limited countries, including countries in Africa. Although COVID-19 has been well studied since the pandemic emerged in Gabon, Central Africa, less attention has been paid to other respiratory viral diseases, and very little data are available. Herein, we provide the first data on the genetic diversity and detection of 18 major respiratory viruses in Gabon during the COVID-19 pandemic. Of 582 nasopharyngeal swab specimens collected from March 2020 to July 2021, which were SARS-CoV-2 negative, 156 were positive (26%) for the following viruses: enterovirus (20.3%), human rhinovirus (HRV) (4.6%), human coronavirus OC43 (1.2%), human adenovirus (0.9%), human metapneumovirus (hMPV) (0.5%), influenza A virus (IAV) (0.3%), and human parainfluenza viruses (0.5%). To determine the genetic diversity and transmission route of the viruses, phylogenetic analyses were performed using genome sequences of the detected viruses. The IAV strain detected in this study was genetically similar to strains isolated in the USA, whereas the hMPV strain belonging to the A2b subtype formed a cluster with Kenyan strains. This study provides the first complete genomic sequences of HRV, IAV, and hMPV detected in Gabon, and provides insight into the circulation of respiratory viruses in the country.
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  • 文章类型: Journal Article
    在低收入和中等收入国家,化脓性链球菌的疾病负担特别高。然而,这些地区的化脓性链球菌分子流行病学数据,尤其是撒哈拉以南非洲,是稀缺的。为了解决这个问题,对来自加蓬的化脓性链球菌进行了全基因组测序(WGS),以识别传播簇,并为公共存储库提供有价值的基因组数据.总共从73名患者中分离出76株化脓性链球菌,在2012年9月至2013年1月之间收集的数据,通过短阅读全基因组测序进行表征。主要的emm类型为emm58.0,emm81.2和emm223.0,占9.2%(76个中的7个),7.9%(76个中的6个),和6.6%(76个中的5个),分别。单核苷酸多态性分析揭示了16个推定的传播簇。其中四个是家庭传输。四个抗微生物基因(lmrP,tetM,tetL,和thfT)在本研究的化脓性链球菌分离物中发现。所有菌株都携带lmrP。在76个分离株中,64(84.2%)携带至少一个四环素抗性基因(tetM或tetL)。与其他公开可用的非洲基因组数据的比较显示,酿脓链球菌的地理位置和遗传多样性之间存在显着相关性。加蓬菌株与肯尼亚和某些大洋洲地区的菌株相似。我们的研究表明,化脓性链球菌的传播可能发生在社区/家庭水平,并且需要高分辨率的分子分型来监测循环克隆的变化并检测社区爆发。应鼓励倡导采用WGS对化脓性链球菌进行全面的分子鉴定,并通过公共存储库进行数据共享,以了解撒哈拉以南非洲化脓性链球菌的分子流行病学和进化轨迹。
    目的:在加蓬进行的研究强调了解决低收入和中等收入国家对化脓性链球菌分子流行病学知识有限的重要性,特别是撒哈拉以南非洲。我们的分子分析确定了主要的emm类型,并揭示了16个假定的传播簇,四个涉及家庭传输。此外,这项研究揭示了地理位置和遗传多样性之间的相关性,强调全面了解化脓性链球菌在不同地区的分子流行病学和进化轨迹的必要性。呼吁通过公共存储库倡导采用全基因组测序进行分子表征和数据共享,对于提高我们的知识和实施有效的战略以打击化脓性链球菌在撒哈拉以南非洲的传播至关重要。
    The disease burden of Streptococcus pyogenes is particularly high in low- and middle-income countries. However, data on the molecular epidemiology of S. pyogenes in such regions, especially sub-Saharan Africa, are scarce. To address this, whole-genome sequencing (WGS) of S. pyogenes from Gabon was performed to identify transmission clusters and provide valuable genomic data for public repositories. A total of 76 S. pyogenes isolates from 73 patients, collected between September 2012 and January 2013, were characterized by short-read whole-genome sequencing. The predominant emm types were emm58.0, emm81.2 and emm223.0 with 9.2% (7 of 76), 7.9% (6 of 76), and 6.6% (5 of 76), respectively. Single-nucleotide polymorphism analysis revealed 16 putative transmission clusters. Four of these were household transmissions. Four antimicrobial genes (lmrP, tetM, tetL, and thfT) were found in the S. pyogenes isolates from this study. All strains carried lmrP. Of the 76 isolates, 64 (84.2%) carried at least one tetracycline resistance gene (tetM or tetL). Comparisons with other publicly available African genomic data revealed a significant correlation between geographical location and genetic diversity of S. pyogenes, with Gabonese strains showing similarities to those from Kenya and certain Oceanian regions. Our study showed that transmission of S. pyogenes can occur at the community/household level and that high-resolution molecular typing is needed to monitor changes in circulating clones and to detect community outbreaks. Advocacy for the adoption of WGS for comprehensive molecular characterization of S. pyogenes and data sharing through public repositories should be encouraged to understand the molecular epidemiology and evolutionary trajectory of S. pyogenes in sub-Saharan Africa.
    OBJECTIVE: The study conducted in Gabon underscores the critical importance of addressing the limited knowledge of the molecular epidemiology of Streptococcus pyogenes in low- and middle-income countries, particularly sub-Saharan Africa. Our molecular analysis identified predominant emm types and unveiled 16 putative transmission clusters, four involving household transmissions. Furthermore, the study revealed a correlation between geographical location and genetic diversity, emphasizing the necessity for a comprehensive understanding of the molecular epidemiology and evolutionary trajectory of S. pyogenes in various regions. The call for advocacy in adopting whole-genome sequencing for molecular characterization and data sharing through public repositories is crucial for advancing our knowledge and implementing effective strategies to combat the spread of S. pyogenes in sub-Saharan Africa.
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  • 文章类型: Journal Article
    背景:本研究旨在评估按蚊幼虫栖息地的空间分布以及与之相关的环境因素,作为实施幼虫的先决条件。
    方法:该研究于2021年12月进行,在短雨季结束(9月至11月)和短旱季(12月至2月)之间的过渡期。Physical,生物,和土地覆盖数据与昆虫学观察相结合,以收集三个主要城镇的按蚊幼虫:Mitzic,Oyem,还有Bitam,在从雨季到旱季的过渡期间使用“浸渍”方法。然后在为研究期间建立的野外实验室中饲养收集的幼虫。按蚊出现后,使用适当的形态分类键鉴定了它们的物种。为了确定环境因素对按蚊繁殖的影响,使用多因素分析(MFA)和二项广义线性模型。
    结果:根据研究,在检查的284个幼虫栖息地中,只有33.1%的按蚊幼虫呈阳性,主要被鉴定为属于冈比亚按蚊复合体。研究结果表明,An的存在。幼虫栖息地中的冈比亚复杂幼虫与各种重要因素有关,例如城市化程度更高,幼虫栖息地(水池和水坑)的大小和类型,与库蚊和伊蚊幼虫共现,环境温度下的热点,适度降雨,和土地利用模式。
    结论:这项研究的结果标志着旨在根除或减少An幼虫栖息地的重点病媒控制计划的启动。加蓬沃劳恩特姆省的冈比亚蚊子。这种方法涉及疟疾通过幼虫传播的根本原因,并且与世界卫生组织(WHO)的全球目标一致,即降低疟疾流行地区的疟疾流行率。
    BACKGROUND: This study aimed to assess the spatial distribution of Anopheles mosquito larval habitats and the environmental factors associated with them, as a prerequisite for the implementation of larviciding.
    METHODS: The study was conducted in December 2021, during the transition period between the end of the short rainy season (September-November) and the short dry season (December-February). Physical, biological, and land cover data were integrated with entomological observations to collect Anopheles larvae in three major towns: Mitzic, Oyem, and Bitam, using the \"dipping\" method during the transition from rainy to dry season. The collected larvae were then reared in a field laboratory established for the study period. After the Anopheles mosquitoes had emerged, their species were identified using appropriate morphological taxonomic keys. To determine the influence of environmental factors on the breeding of Anopheles mosquitoes, multiple-factor analysis (MFA) and a binomial generalized linear model were used.
    RESULTS: According to the study, only 33.1% out of the 284 larval habitats examined were found to be positive for Anopheles larvae, which were primarily identified as belonging to the Anopheles gambiae complex. The findings of the research suggested that the presence of An. gambiae complex larvae in larval habitats was associated with various significant factors such as higher urbanization, the size and type of the larval habitats (pools and puddles), co-occurrence with Culex and Aedes larvae, hot spots in ambient temperature, moderate rainfall, and land use patterns.
    CONCLUSIONS: The results of this research mark the initiation of a focused vector control plan that aims to eradicate or lessen the larval habitats of An. gambiae mosquitoes in Gabon\'s Woleu Ntem province. This approach deals with the root causes of malaria transmission through larvae and is consistent with the World Health Organization\'s (WHO) worldwide objective to decrease malaria prevalence in regions where it is endemic.
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  • 文章类型: Journal Article
    背景:Loaloa的慢性感染仍然是一个未解决的免疫学悖论。尽管有皮下迁移的成虫和经常高密度的微丝虫,大多数患者只有相对轻微的症状,然而,杀微丝治疗可引发危及生命的炎症.这里,我们调查了假设在这两种疾病中发挥作用的先天细胞群,在加蓬的特有人群中。
    结果:我们分析了嗜酸性粒细胞和嗜碱性粒细胞的数量和激活,以及骨髓来源的抑制细胞(MDSC)亚群和相关的循环细胞因子水平通过流式细胞术在性别和年龄匹配的L.loa未感染(LL-),-微丝血症(MF-)和-微丝血症(MF)个体(n=42),以及阿苯达唑治疗的微丝血症个体(n=26)。IL-嗜酸性粒细胞的百分比(3.0%)低于合并的L.loa感染人群,但MF+(13.1%)和MF-(12.3%)相似。MF+处理后,嗜酸性粒细胞增多从第0天(17.2%)至第14天(24.8%)增加,并在第168天(6.3%)降低至基线以下。嗜酸性粒细胞活化标志物CD123的表达遵循与嗜酸性粒细胞百分比相同的模式,而CD193和一定程度的CD125则相反。治疗后循环IL-5水平遵循与嗜酸性粒细胞动力学相同的模式。嗜碱性粒细胞数量在感染状态之间没有差异,但在MF治疗后增加。我们没有观察到感染状态之间或治疗后的MDSC数量差异。
    结论:我们证明,在这种情况下,慢性感染和L.loa微丝血症的治疗都与嗜酸性粒细胞循环和不同的表型激活标志物相关,这些标志物可能有助于炎症途径。在对L.loa感染中MDSC的首次调查中,我们没有发现证据表明他们在慢性Loiasis中的存在增加,表明L.loa的免疫调节是通过其他途径诱导的。
    BACKGROUND: Chronic infection by Loa loa remains an unsolved immunological paradox. Despite harboring subcutaneously migrating adult worms and often high densities of microfilariae, most patients experience only relatively mild symptoms, yet microfilaricidal treatment can trigger life-threatening inflammation. Here, we investigated innate cell populations hypothesized to play a role in these two faces of the disease, in an endemic population in Gabon.
    RESULTS: We analyzed numbers and activation of eosinophils and basophils, as well as myeloid-derived suppressor cell (MDSC) subsets and associated circulating cytokine levels by flow cytometry in sex- and age-matched L. loa-uninfected (LL-), -amicrofilaraemic (MF-) and -microfilaraemic (MF+) individuals (n = 42), as well as microfilaraemic individuals treated with albendazole (n = 26). The percentage of eosinophils was lower in LL- (3.0%) than in the combined L. loa-infected population, but was similar in MF+ (13.1%) and MF- (12.3%). Upon treatment of MF+, eosinophilia increased from day 0 (17.2%) to day 14 (24.8%) and had decreased below baseline at day 168 (6.3%). Expression of the eosinophil activation marker CD123 followed the same pattern as the percentage of eosinophils, while the inverse was observed for CD193 and to some extent CD125. Circulating IL-5 levels after treatment followed the same pattern as eosinophil dynamics. Basophil numbers did not differ between infection states but increased after treatment of MF+. We did not observe differences in MDSC numbers between infection states or upon treatment.
    CONCLUSIONS: We demonstrate that both chronic infection and treatment of L. loa microfilaraemia are associated with eosinophil circulation and distinct phenotypical activation markers that might contribute to inflammatory pathways in this setting. In this first ever investigation into MDSC in L. loa infection, we found no evidence for their increased presence in chronic loiasis, suggesting that immunomodulation by L. loa is induced through other pathways.
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